ABSTRACT
Background: Mechanisms responsible for sensitivity to irritants such as tobacco smoke are poorly understood. A Tobacco Score questionnaire was developed to identify and characterize subjects with this sensitivity. For this pilot study, scores were assessed in populations of self-selected controls and a group with irritant sensitivity (Chronic Fatigue Syndrome, CFS).
Method: Subjects graded the severity of 21 symptoms associated with tobacco exposure. Results were compared with other instruments and a measure of pain sensitivity (dolorimetry) in 116 control and 103 CFS subjects.
Results: The Tobacco Score was positive in 16% of control and 51% of CFS subjects. Significant correlations were found between Tobacco Score, Irritant Rhinitis Score and history of sinusitis. Intermediate relationships were found with history of allergic rhinitis, Systemic Complaints Score and Multiple Chemical Sensitivity. Factors having no influence included gender, the severity of CFS symptoms, pain thresholds, and allergy skin tests.
Conclusions: Tobacco sensitivity was correlated with measures of upper airway irritation and nonallergic sensitivity to triggers such as weather changes. The spectrum of symptoms, high prevalence in CFS, and absence of a relationship to atopy suggest that these nonallergic irritant syndromes may share a common neuropathophysiology.